Study: City safer than country

When it comes to deaths from injuries, urban states fare better than rural ones

Aug. 5, 2013

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By the Numbers

2.4: Deaths per 100 million miles driven in S.D. in 2003 1.5: Deaths per 100 million miles that year in the U.S. 1.5: Deaths per 100 million miles in S.D. in 2012 1.2: Deaths per 100 million miles in U.S. in 2012 40: Percentage of South Dakota’s 133 vehicle-related fatalities in 2012 that were related to drunken driving.

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A recent study on mortality turns conventional wisdom on its head: “If you consider safety as your risk of injury overall, we found that you’re actually safest in larger cities and get less safe as the areas become more rural.”

That is the assessment of Dr. Sage Myers, lead author of the University of Pennsylvania study published in July in the Annals of Emergency Medicine. The study sorted by cause almost 1.3 million injury-related deaths in the U.S. from 1999 to 2006, excluding the 9-11 terrorist attacks.

Plowing deeper into the data, though, shows the major risk to safety is vehicle accidents.

In this regard, South Dakota vehicle fatalities are higher than both the national average and the average of nearby states with metropolitan centers, such as Minnesota, Iowa and Nebraska. But during the past decade, South Dakota steadily has been closing the gap. Vehicle-related deaths have declined here at a faster rate than they have in the country overall.

In 2003, South Dakota had 2.4 deaths per 100 million miles driven, according to the South Dakota Department of Public Safety’s Motor Vehicle Traffic Crash Summary. The national average that year was 1.5 deaths per 100 million miles driven. Nationally, that rate has crept downward. In 2012, it was 1.2.

Beginning in 2007, however, South Dakota began to bend its curve down more aggressively. The rate declined from 2.3 deaths in 2007 to 1.7 in 2007, to 1.4 in 2008. It bumped upward slightly in 2009 to 1.5 and 1.6 in 2010 before falling to 1.2 in 2011 and 1.5 last year.

The declining vehicle accident death rate the past five years is the accumulation of a variety of projects to address safety, according to Lee Axdahl, director of the state Office of Highway Safety.

“There’s a lot of grassroots stuff going on. It all plays a part.”

Two notable efforts are to reduce drunken driving and to work with Native American tribes on road safety.

“Our shining star is Pine Ridge. We hold that partnership in very high regard. It’s showing some difference,” Axdahl said.

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Other states in region safer on road

The University of Pennsylvania study depicting urban areas as safer than rural ones resonates with fatal vehicle accident data from this region.

Minnesota, with the Twin Cities, had a death rate per 100 million vehicle miles of .07 in 2012. Nebraska, with Omaha, had a 1.1 rate in 2012, and in Iowa, with Des Moines, the rate was 1.2.

Conversely, in 2011, the last year for which comparable statistics were available, Montana and Wyoming had death rates per 100 million miles of 1.8, and North Dakota’s was 1.6.

Last year in South Dakota, 133 people died on the state’s roads.

Almost 40 percent of the deaths were alcohol-related, and of the 40 percent, almost half were of people younger than 30.

Drunken driving
a significant factor

Rural driving and impaired driving are a deadly combination that account for a large measure of the statistical variation between rural and urban areas, Axdahl said.

“So many impaired driving deaths happen in rural areas where you are unlikely to be found and unlikely to get help.”

Gun deaths about even among states

Firearms-related deaths trailed those involving vehicles. But they still were a notable safety threat.

The study found no significant difference between urban and rural counties in the overall risk of firearms-related deaths.

However, among

adults aged 20 to 44, the risk of being shot and killed was greater in urban settings.

Conversely, for children up to age 14 and for adults older than 45, firearms-related deaths were greater in rural areas.

The study didn’t differentiate between gun violence and firearms accidents.

Nor did it speak to any distinction in the concentration of firearms in a rural setting compared to an urban one.

Hunting deaths
play small role

The phenomenon of pheasant hunting, though, annually draws hundreds of thousands of hunters with shotguns to South Dakota’s fields, and the state features abundant waterfowl and big game hunting, as well.

However, in recent years the number of hunting accidents never has exceeded 40 per year.

Aside from a spike in 2011, hunting accidents have either oscillated modestly or declined since 2008, according to the South Dakota Department of Game Fish and Parks.

In 2008, there were 31 accidents reported, including one fatality. In 2009, number of accidents increased to 39 with one fatality.

In 2010, the numbers were 35 and one. In 2011, accidents jumped to 55, with a single fatality.

But last year, the number of total accidents dropped to 21, the lowest level of reported accidents since 1997, when there were 18.

The number of hunting fatalities did go up last year.

Three people died. But only one of the deaths involved a firearm.

In the other incidents, a hunter suffered a fatal heart attack, and a hunter died after falling from a tree stand.